New Delhi: The large number of people who are in need of medical aid globally, abduction and risk to lives and the mistrust of humanitarian aid bodies by local governments are all challenges that humanitarian organizations like Médecins Sans Frontières (or Doctors Without Borders) face in their pursuit of providing medical aid to the needy, said Dr Unni Krishnan Karunakara, MSF's International President.

"More than 8 million patients visited our hospitals and clinics last year. This is a huge figure, but in fact, these 8 million represent just a fraction of the number of people who needed medical attention, " Karunakara said at a discussion organized by them late Friday in the capital

"Most had to go without care. In many places around the world, humanitarians are unable to bring the assistance that is required, because their presence is not accepted, and humanitarian medical action is not respected," Karunakara said, citing an example of how two colleagues -- Mone Serra and Blanca Thiebaut -- remain captive in Somalia even after 576 days.

Serra and Thiebaut were abducted while working in one of the refugee camps in Dadaab, Kenya.

Reuters

Karunakara also said that the lack of respect for humanitarian action often leads to organisations suspending their activities or reducing their services -- a consequence of which is thousands of people who need medical attention do not get it.

"In Syria, early in the conflict, people injured in protests stopped going to public hospitals for fear of arrest. Doctors risked arrest and being labelled ‘enemies of the regime’ for treating the injured. 57 per cent of public hospitals have been damaged and more than one third are estimated to no longer be functioning. Some communities are refusing the set-up of medical facilities because of the fear that they will attract air raids," he said.

In many places like in India's Chhatisgarh, organizations like MSF are suspected of being agents of foreign governments, some rightly so -- like the National Red Crescent societies of Qatar and Turkey -- which are all legal auxiliaries to their governments.

In 2010, 158 governments donated funds for humanitarian assistance, a 51 per cent increase on 2008. And these new donors are structuring and institutionalising their activities. Last year India created the ‘Development Partnership Agency’, seeking to ‘consolidate and streamline outgoing aid’. By some accounts, the DPA plans to provide US 15 billion dollars in assistance in the next 5 years.

But Karunakara said that while this new world order emerges, including more states and more organizations, it's not fair to paint all humanitarian organizations with the same brush.

"Here in India, our activities have been questioned. Our humanitarian activities in Chhattisgarh, for example, have not always been understood. Indeed, some time ago, MSF was accused of helping Maoists by some district authorities. Let me repeat, MSF is a humanitarian organisation. We are neutral, independent and impartial. We provide medical assistance according to need," he said.

Karunakara, however, accepted that the sector has seen an increasing dependency between donor governments depending on NGOs to implement their objectives in conflict settings, and NGOs depending on donor governments to safeguard their presence in these crises. While imparting a cautious note on it, Karunakara said that he understood the perception of many people, who thought that aid agencies were not impartial.

"Given this context, it is easy to understand the perception of local people that aid agencies are contributing to the war effort and state-building policies of one side to the conflict.

In Afghanistan, what we see is that the massive resources of the aid system, both UN and NGO, support the Afghan government and the political and foreign policy objectives of the intervention forces. With aid no longer perceived as impartial, it is no wonder that opposing armed groups or repressive governments may not want humanitarian actors around," Karunakara said.